• Title/Summary/Keyword: lack of family

Search Result 698, Processing Time 0.023 seconds

A Study of Industrial Patients from Selected General in the Kyung Pook and Taegu City areas (일부지역 산업재해환자 실태 조사 연구 -대구${\cdot}$경북지역 일부 종합병원 중심으로-)

  • Huh, Choon-Bok
    • The Journal of Korean Physical Therapy
    • /
    • v.3 no.1
    • /
    • pp.151-174
    • /
    • 1991
  • The purpose of this study is to research the actual conditions of industrial accident patients and to produce worker satisfaction and a rational and effective counter measure plan. Direct interviews with 179 cases (in and out patients) were carried out during a three month period from April to July 1990, at six hospitals : two general hospitals Sun Lin and Sung Mo in Po Hang, and four general hospitals in Taegu : Kyung pooh University Hospital, Dong San Medical Center, Young Nam Medical Center and Catholic Hospital. The results of this study are summarized as fellows : 1. Among the 179 cases, $51.6\%$ were male and $48.4\%$ were female. The two largest age groups were 30-39, $31.8\%$ and 20-29, $27.4\%$. Among the 179 cases, $51.6\%$ were married, the largest family number was 2 to 3, $41.1\%$ and 4 to 5, $25.6\%$. Educationally, graduation from high school was the largest group, $46.4\%$ among ,the patients, followed by middle school and primary school. The largest group income level was from 40-69 만원, $45.2\%$. The largest group of patients who worked over 50 hrs. a week was $52.0\%$. The largest group of patients who worked less than 1 year was $44.7\%$, of the patients in work places of less than 100 people, $60.3\%$ were injured and in work places of 100-299 people, $20.1\%$ were injured. In manufacturing, the largest group injured was $55.3\%$, the next group was transport, storage, communication. The largest group of production workers injured was $40.2\%$. 2. The cause of injury in the largest group was facility problems, $33.5\%$. The next group was unsafe habits, $30.2\%$ ; a lack of safety knowledge, $17.9\%$ ; and insufficient supervision, $12.3\%$. The 30-39 year age group head the highest number of injuries, $40.4\%$ ; work places with more than 10 years of work, $44.4\%$ ; work places with more than 1000 people, $56.3\%$ and mining accidents, $80.0\%$. Among. these groups the highest cause of injury was due to facility problems. 3. The accident pattern showed machinery injuries $28.5\%$ as the largest group, followed by falls & falling objects $17.3\%$, fire & electric $15.1\%$, strucke by an object $14.5\%$, followed by overaction and vehicular accidents. The accident pattern showed $46.4\%$ among workers over the 50 year age group, workers in the 5-10 year group, $50.0\%$ ; places employing more than 1000 workers, $35.3\%$ ; construction $73.7\%$, and construction workers $57.1\%$, among these fall & falling objects caused the greatest number of injuries. 4. The largest group of injuries was fractures $54.8\%$, trauma $14.5\%$, amputation $11.7\%$, open wound, and burns. The largest number of fractures occurred in people in the 30-39 year age group, $63.2\%$ : over 10 years of work, $55.0\%$ ; in work places of 300-490 people, $63.6\%$ ; construction $63.2\%$ and general workers $57.2\%$. 5. The largest group of injuries was upper extremity $45.3\%$, lower extremity $24.0\%$, trunk $18.5\%$ and head or neck $12.2\%$. Of these groups, upper extremity injuries were the highest in those less than 20 years old $75.0\%$, less than 1 year or work $59.5\%$, in work places of 500-999 people $60.0\%$, manufacturing $56.6\%$ and production workers $55.6\%$. 6. Periods of injury showed 34 people injured in September, to be the largest followed by October, 32 ; August, 22 people : July, 19 people and the lowest December, 2 people. During the week, Friday had the largest group injured, 35 people ; followed by Saturday, 26 people and the lowest was Wednesday, 17 people, During the day 1400 hours had the largest group injured, 38 people ; followed by 800 hours, 31 people. 7. On a basis of 5 as the highest mark, the average, according to worker satisfaction showed facility safety 3.55, work environment 3.47, income 3.44, job 3.21 and treatment 2.98. 8. The correlation between general characteristics and injury showed that age was directly correlated to the duration of work (r=2591) p<0.01, age was directly correlated to industry (r=2311) p<0.01, and the duration was directly correlated to occupation (r=4372) p<0.001.

  • PDF

The Hospital Life of the Patient with Femoral Neck Fracture (대퇴경부 골절 환자의 입원 생활)

  • Kim, Kyung-Ja;Chi, Sung-Ai
    • Journal of Korean Academy of Nursing Administration
    • /
    • v.2 no.1
    • /
    • pp.35-56
    • /
    • 1996
  • Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

  • PDF

Seasonal and Spatial Distribution of Soft-bottom Polychaetesin Jinju Bay of the Southern Coast of Korea (진주만에서 저서 다모류의 시 · 공간 분포)

  • Kang Chang Keun;Baik Myung Sun;Kim Jeong Bae;Lee Pil Yong
    • Korean Journal of Fisheries and Aquatic Sciences
    • /
    • v.35 no.1
    • /
    • pp.35-45
    • /
    • 2002
  • Seasonal quantitative van Veen grab sampling was conducted to characterize the composition and structure of the benthic polychaete community inhabiting the shellfish farming ground of a coastal bay system of Jiniu Bay (Korea). A total of 132 polychaete species were identified and the polychaetes accounted for about $80\%$ of overall abundance of benthic animals. There was little significant seasonal difference in densities (abundances) of polychaetes, Maximum biomass was obseued in summer (August) and minimum value was recorded in winter (February) and spring (May). Conversely, diversity and richness were lowest in summer, indicating a seasonal variability in the polychaetous community structure, The cluster analysis indicated that such a seasonal variability resulted mainly from the appearance of a few small, r-selected opportunists in spring and the tubiculous species of the family Maldanidae in summer. On the other hand, several indicator species for the organically enriched environments such as Capitelia capitata, Notoniashs Jatericeus and hmbrineris sp. showed high densities during all the study period. Density and biomass of univariate measures of community structure were significantly lower in the arkshell-farming ground of the southern area than in the non-farming sites of the bay, A similar general tendency was also found in the spatial distributions of species diversity and richness. Principal component analysis revealed the existence of different groups of benthic assemblages between the arkshell-farming ground and non-farming sites, The lack of colonization of r-selected opportunists and/or tubiculous species in the former ground seemed to contribute to the spatial differences in the composition and structure of the polychaetous communities. Although finer granulometric composition and high sulfide concentration in sediments of the arkshell-farming ground and low salinity in the northern area were likely to account for parts of the differences, other environmental variables observed were unlikely. The spatial distribution of polychaetes in Jiniu Bay may be rather closely related to the sedimentary disturbance by selection of shells for harvesting in spring.

A Study on The Nursing Needs of Users and their Service Status at Short-Stay Centers for The Elderly (단기노인보호소 이용자의 간호요구도 및 서비스 실태연구)

  • Shin Kyoung Hi;Rhee Seon Ja
    • Journal of Korean Public Health Nursing
    • /
    • v.16 no.2
    • /
    • pp.354-377
    • /
    • 2002
  • Aging population is a global trend and Korea is no exception. Due to the progress of the medical and scientific sectors, increase in the average lifetime incurred increase in the number of elderly people. Meanwhile, the family function of supporting the elderly has become a major issue in a society due to the changes in the society's structure and increased entry of the women into the workforce. As a means to substitute the protection of the elderly who are not protected at their respective homes and to replace the tending needs, weekly protection centers and short-stay centers for the elderly were established and operated in Seoul since 1992. However, structured and satisfactory services are not yet to be provided, thus this research intends to understand the current situation at the short-stay centers for the elderly, to identify users' characteristics and to conduct study on nursing need for the health reasons so that the results of the research can be utilized as basic data for the development of nursing care program. Towards this end, this research targeted 142 elderly people who were undergoing treatment at the 11 short-stay centers for the elderly out of total of 13 located in Seoul that were willing to cooperate. The research was conducted from April to May 2002, with the measurement tool developed by Rhee, Seon-ja (2001) to measure the level of nursing need. Then data was collected and analyzed using SPSS program. The results are as follows. The general characteristics of users of the short-stay centers for the elderly were: 123 females $(86.6\%)$, 19 males $(13.4\%)$ and 72 elderly were over the age of 80 $(50.7\%)$. Among these, 24$(16.9\%)$ were living by themselves. Among the illnesses that the subjects were inflicted with were: dementia $(54.2\%)$, stroke $(54.1\%)$ and high blood pressure $(50.7\%)$, in the respective order. Despite the fact that they were diagnosed with illnesses, $47.2\%$ responded that they do not undergo special treatment due to financial reasons. When the level of needs for nursing care among the elderly who use the short-stay centers is divided into informational. physical. and emotional need levels and scored between zero to two, the level of emotional need is the highest with 1.80, followed by physical (1.45) and informational (1.44) need levels. As for the realities of services at the centers and improvement areas, restriction on term was cited as the greatest inconvenience with $38.7\%$, followed by lack of budget (24 respondents, $16.9\%$). Wishful services were financial assistance $(46.5\%)$, medical and nursing services $(40.1\%)$, meal provision service $(8.5\%)$ and counseling service $(4.9\%)$, in the respective order. Based on the above mentioned results, the research identified the need to develop nursing program for the patients of dementia that can be applied onto the short-stay centers and the need to develop volunteer service, backed by societal support. Also, placement of specialized cadre of professionals is needed so that medical and nursing service functions can be provided in a complementary manner.

  • PDF

Inappropriate Care of Oncologic Emergency in Korea (암환자 응급진료의 현황 및 문제점)

  • Heo, Dae-Seog;Yun, Young-Ho;Jeong, Joo-Young;Kim, Hong-Soo;Kim, Sung-Hye;Shin, Sang-Do;Rhee, Joong-Eui;Oh, Eun-Kyung;Yoo, Chul-Gyu;Bang, Yung-Jue;Kim, Noe-Kyeong
    • Journal of Hospice and Palliative Care
    • /
    • v.1 no.1
    • /
    • pp.14-22
    • /
    • 1998
  • Purpose : Cancer is a common cause for admission to emergency room(ER). Cancer patient present to ER with undiagnosed cancer, acute vague problem of cancer, or treatment related complication. But there is little information on the magnitute of the problems in the Korea. The purposes of our study were to evaluate the appropriateness of care for oncologic emergencies in Korea. Materials and Methods : This study was undertaken of all cancer patients above 15 years old presenting to the Seoul National University Hospital ER, who visited during the period from Oct. 16 to Nov. 15, 1997. ER record was reviewed and ER doctors evaluated patients' reason for visiting ER, appropriateness in patients' utilization of ER, oncology emergency Results : 266 cancer patients(17.4% of total patients) visited ER during this period and 166 cancer patients(62.4%) utilized inappropriately ER. Their average stay is 32.0 hours and 65.8% of them stayed for 6 hours. There were complaints of patients such as pain(44.8%), abdomen distension(9.4%), and dyspnea(7.5%). The most common oncologic emergency in ER during this study were gastrointestinal(34.0%), neurologic(21%), hematologic(8.0%), infectious(7.0%), respiratory(6.0%), and genitourinary(5.0%). Conclusion : For the care of symptoms like pain, most of cancer patients utilize ER inappropriately due to lack of attention from primary health delivery system. For the better care, the palliative medicine should be established in Korea.

  • PDF

The Operation of Home Economics Education Course in Graduate School of Education and the Graduate Students' Perception (서울소재 교육대학원 가정교육전공 교육과정에 대한 운영실태와 교육대학원생의 인식)

  • Lee, Seon-Jung;Shin, Hye-Won
    • Journal of Korean Home Economics Education Association
    • /
    • v.20 no.4
    • /
    • pp.173-186
    • /
    • 2008
  • This study aimed to examine the operation of the Home Economics education courses in the graduate schools of education, and to find out how graduate students perceive them. Data were collected with the use of handbooks issued by 11 graduate schools of education located in Seoul, and through telephone conversations with the administrative staff. To determine how graduate students majoring in Home Economics perceive their Home Economics courses, a survey was conducted among the graduate students in 10 graduate schools of education, and a total of 131 accomplished questionnaires were used for data analysis. The results of the study are as follows. First, all 11 graduate schools aimed to retrain their teachers, enhance their professionalism, and produce home economics education experts. The Home Economics Education courses come in two strands; a teacher's course and a major course. Most of the schools require a total of 30 credits. All Schools lack professors. Only 3 graduate schools have a home Economics Department in the College of Education. All graduate schools are offering a teacher's course based on a teacher's certification system. In a major course, Home Economics education has the largest number of subjects, with Clothing and Textiles and Food and Nutrition being given greater emphasis, and Consumer Economics, Home Economics Management, Child Care, and Family and Housing Studies being given less emphasis. Second, they mostly regard the graduate school of education as producer of experts, followed by producers of teachers and teacher re-trainers. Those who were majoring in Home Economics Education in college, and the teachers, are more interested in teacher re-training, while the non-teachers and those who were not majoring in Home Economics Education are more interested in producing teachers. They are less satisfied with the operation of the graduate school of education. But they are generally satisfied with the Home Economics Education course. Graduate students registered the lowest satisfaction with a major course, especially experimental subjects. For a teacher's course, the graduate students who are not teachers exhibited higher satisfaction, whereas the teachers showed lower satisfaction. But teachers registered more satisfaction with the practical use of major subjects in the educational field, thinking that their major was a big help in their work at a school. As for what has to be improved with regard to the Home Economics Education course, many cited the necessity of securing a good faculty and expanding the major subjects.

  • PDF

CHILDHOOD TRAUMA:RESILIENCE AND RISK FACTORS ON DEVELOPMENTAL TRAJECTORY (소아기 외상 : 발달경로에 따른 보호 및 위험인자)

  • Kim, Young-Shin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.13 no.1
    • /
    • pp.15-23
    • /
    • 2002
  • Knowledge regarding the resilience factors and risk factors of the childhood trauma on the developental trajectory is in its infancy due to the lack of prospective follow-up studies in the childhood trauma and limited understanding of the complex reciprocal interactions between childhood trauma, develop-ent and various aspects of children's environment. These difficulties in the conceptual framework and research methods in the childhood trauma are partly reflected in the inconsistencies, even controversies, of the results in the childhood trauma researches. Despite these difficulties, common aspects of the risk factors and resilience of the childhood trauma on the development can be identified from the previous studies. The resilience to the negative outcome on the development by childhood trauma includes:sex female before puberty, male after puberty or infancy), high socioeconomic status, no organic problem, easy temperament, no previous experience with early loss or separation, younger age at the trauma, better problem solving capacity, high self-esteem, internal locus of control, high coping skills, ability to identify interpersonal relationships, ability to play, sense of humor, having capable parents, having a warm relaionship with at least one of the parents, high education and participating in the organized religious activities. These commonalities of the results suggest that risk and resilient factors of the childhood trauma are interdependent, each factor has multiplicity in the impacts on the children's development according to the developmental stage of the child, family and children's other environment, trauma and stressor have diverse effects according to their intensity and risk and resilience factors could have synergistic or antagonistic effects to each other. To develop comprehensive understanding on the relationship between childhood trauma and developmental psychopathology, risk and resilience factors and to develop effective and efficient prevention and intervention, research on the effect of the stress on the neurodevelopment, on the individual differences of the response to the trauma including genetic factors and constitution, and on the brain plasticity should be accompanied in the future.

  • PDF

Risk Factors of Primary Nocturnal Enuresis (일차성 야뇨증의 위험 요인)

  • Lee, Soo-Jin;Yang, Jung-An;Yoo, Eun-Sun;Seo, Jang-Wan;Lee, Seung-Joo
    • Childhood Kidney Diseases
    • /
    • v.4 no.1
    • /
    • pp.69-76
    • /
    • 2000
  • Purpose: The Pathogenesis of primary noctllrnal enuresis(PNE) is still controversial. Genetic factor and maturational delay of micturition reflex including arousal disorder, lack of nocturnal Arginine Vasopressin(AVP) release and functional bladder capacity have been suggested. We analyzed the risk factors of PNE. Methods: Fifty five children with PNE (20 enuretics diagnosed at school physical examination of the first grade students at Mok-Dong Elementary School and 35 enuretics (Age 6-7 year) diagnosed at Ewha Womans University Mok Dong Hospital) and 221 control students without PNE at school physical examination were included. Genetic, stress and developmental factors, arousability, water intake, urine volume, maximun voiding volume and daytime voiding dysfunction were compared. Results: 1) There was no significant difference between PNE and control group in sex ratio, birth order, percentage of working mothers, parental and child personality, age to start walking, school record and duration of sleep. 2) Family history in the PNE group was significantly higher than control group ($20.0\%\;vs\;2.7\%$)(P<0.05). 3) The difficulty in arousal in the PNE group was significantly more common than the control group ($70.9\%\;vs\;54.3\%$)(P<0.05). 4) Nocturnal water intake in the PNE group was significantly greater than the control group ($330{\pm}158.2\;mL\;vs\;235{\pm}129.5\;mL$). Nocturnal urine volume in the PNE group was significantly greater than the control group ( $390{\pm}61.5\;mL\;vs\;140{\pm}43.2\;mL$)(P<0.05). Daily water intake and daily urine volume did not significantly differ between the two groups. 5) Maximum urine volume per void in the PNE group was significantly lower than the control group ($107{\pm}35.9\;mL\;vs\;236{\pm}41.3\;mL$). Daytime voiding dysfunction in the PNE group was significantly more common than the control group ($80.0\%\;vs\;57.9\%$). The voiding frequency in the PNE group was significantly greater than the control group ($7.0{\pm}3.6\;vs\;5.4{\pm}1.6$)(P<0.05). Conclusion: In addition to genetic factors and maturational delay of micturition reflex (difficulty in arousal, nocturnal polyuria and decreased functional bladder capacity) nocturnal polydypsia was found to be the important risk factors fur PNE. So nocturnal fluid restriction should be encouraged as the first-line management of PNE.

  • PDF

User Behavior and Improvement for Kumgang Pine Eco-Forest in Uljin (울진금강송 생태숲의 이용자 행태분석과 개선방안)

  • Oh, Nam-Hyun
    • Korean Journal of Environment and Ecology
    • /
    • v.22 no.3
    • /
    • pp.249-259
    • /
    • 2008
  • The purpose of this study was to analyze the users' behaviors and to suggest development strategies in Uljin Kumgang pine tree(Pinus densiflora for. erecta) eco-forest(UKPEF), which is located in Kyeongbuk. The data were collected by interviewing 122 visitors to september 3 from august 29, 2007 with a constructed questionnaire. The results of the analysis are as follows. 1. The major visitors of UKPEF are male and the age between 20 to 30, the residents of the Uljin county with relatively high academic background. 2. The motive of visiting UKPEF is mainly by the beauty and taste of Kumgang pine tree and the condition of the forest. The visitors are mainly composed of family, not big group. 3. The visitors of UKPEF have obtained information about the Kumgang fine tree forest mainly from friends, not from the internet or travel agency. 4. The visitors of UKPEF pointed out lack of convenient facilities such as toilets and water-supply facilities. However, visitors are satisfied by the condition of the forest. 5. The visitors of UKPEF set a high value on Kumgang fine tree, So, more active marketing strategy about Uljin Kumgang pine tree has to be established. 6. The visitors of UKPEF are more satisfied by the Uljin Kumgang pine tree forest than expected. The development strategies of UKPEF are suggest as follows. (1) Auto tram system has to be set up and new trail should be constructed to attract more visitors and people of other regions. (2) To attract group tourists, new program should be developed. (3) Advertisement through internet or travel agency has to be developed. (4) Government(local) should make a plan to register the forest as World natural heritage. (5) Monitoring and evaluation system has to be developed to satisfy tourists. In conclusion, the efforts of taking care of and preserving the UKPEF should be made at the national level. I hope that more Koreans can have chance to feel and experience the value and excellence ofthe Uljin Kumgang pine tree(Pinus densiflora for. erecta)

The Effect of Teacher Support Program for the Integration of Handicapped Children on Teaching Efficacy of Daycare Center Teachers (장애 유아 통합보육을 위한 교사 지원이 어린이집 교사의 교사 효능감에 미치는 영향)

  • Park, Na Ri
    • Korean Journal of Child Education & Care
    • /
    • v.18 no.4
    • /
    • pp.247-265
    • /
    • 2018
  • Objective: The purpose of this study was to investigate the effect of teacher support program for integration of handicapped children on teaching efficacy of daycare center teachers. Methods: In the study, 12 day care teachers in 4 day care centers in Seoul and Gyeonggi area were selected as experimental groups and 12 teachers in 5 day care centers were selected as control group. Teacher education is carried out through group education, such as understanding of developmental area, curriculum modification, activity-based embedded intervention, cooperative learning, direct teaching, disability understanding education, behavior support, family support. Individual teacher education provided counseling on the reality of child care for children with disabilities that reflects the needs of teachers for integrated child care for handicapped children. Teacher's Efficacy in Inclusive Practices (TEIP) was used as a pre post test to measure teacher's efficacy change. In order to analyze the results of the study, two independent sample t tests were conducted on the difference between pre-post test of teacher efficacy between the two groups. Results: As a result, There was a significant difference in the pre-post change of teacher efficacy between the two groups. Conclusion/Implications: The results of this study are as follows, teacher support program provided immediate feedback in integrated child daycare center for the handicapped children, child care teachers improved their integrated handicapped children care expertise, provided responsive teacher support program to the actual needs of the site, teacher support program reflected various variables related to integration, and emphasized the cooperative relationship between researcher and child daycare center teacher. The results of this study can be used as actual data of field where lack of support for the integration of handicapped children is lacking.